Caries (untreated teeth) is the most prevalent disease in the world. In Japan, more than 30% of the population is affected. In addition, as the loss of teeth decreases, the number of elderly patients has been remarkably increasing. However, the high prevalence of dental caries is not fully recognized due to decrease in caries in children. The trend of dental visits, which was previously considered as “drilling teeth in early childhood, losing teeth in middle-age and older age, and not seeing in older age”, is now “caries prevented in early life, and dental visits continued in older age. The track has changed. This change has created a gap between the reality and the health insurance system. For this reason, it has become a requirement of the time to include the evaluation of prevention in universal health insurance and to place regular checkups in the medical fee chart. In order to realize dental care that reduces the number of treatment visits and shifts to increment of regular dental check-ups, there is a need to reform the awareness of those involved in governments, research, education, and clinical practice.

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The chief complaints of new patients at general dental clinics seemed associated with repaired teeth. To scrutinize this, we conducted a survey on clinical data. The subjects were 718 new patients at 20 clinics during the period of Sept. 1 to Nov. 30, 2017 (out of 48 JHCDA member clinics participating in this study, i.e., data collected at 28 clinics collected were incomplete). As a result, the cause of the chief complaint related to teeth with no treatment history was 10% of the total while repaired teeth related complaints amounted to 43%. It was suggested that adult patients are likely to visit the dental clinic for re-treatment of a repaired tooth.

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The purpose of this survey was to examine 2-3 years-old and 4-5 years-old children, who visited the dental clinic for the first time, clarifying the differences in caries-related factors in these age groups. The subjects included in the survey were 134 patients (68 boys and 66 girls) aged 2 to 5 years who visited the Fujiwara Dental Clinic for the first time during the period of April 2016 to March 2019. The survey method was based on the medical records taken at the first visit, caries-related factors in particular, analyzing the differences in lifestyle and daily habits in the age groups of 2-3 years old (61 children) and 4-5 years old (73 children). As a result of the Fisher’s exact test, the factors significantly related (p <0.05) to the presence of caries for all the subjects were “sex” and “regularly eating sweets”, for 4-5 years-old children were “sex”, “use of tooth paste”, and “regularly eating sweets” while there were none for the 2-3 years-old group. Logistic regression analysis showed significantly related (p <0.05) factors as follows: in order of odds ratio, for all subjects “sweet snacks” and “sex”, for 2-3-year-olds “sex”, and for 4-5-year-olds “regularly eating sweets”, “use of tooth paste” and “sex”. The result of this survey showed that the factors associated with life such as “use of tooth paste” and “regularly eating sweets” were significantly related to caries in the group of 4-5 years old children but not in the group of 2-3 years old. It was suggested that improvement of lifestyle habits becomes increasingly important for caries prevention in the older preschool children.

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We have taken standardized photographs of occlusal surfaces of permanent teeth from the eruption of the first molar to age of 20 for two purposes: To better examine the occlusal surface of the permanent teeth and to better explain the stain on the occlusal surface, which was “checked” as caries at school dental check-ups to the patients and their guardians. Photographic recording of the occlusal surfaces provides not only complementary information in examination, but also clue to the causes (poor plaque control, deep fissure, enamel hypoplasia, etc) in case of developing caries. This report is to introduce the standardized photographic recording method adopted at our clinic.

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By text mining using artificial intelligence IBM Watson®, we analyzed the relationship between dental hygienist clinical records at Fujiwara Dental Clinic and extraction. Text mining is an analysis method that divides freely written sentences into words and calculates their appearance frequency and correlation with specific items. As a result, expressions, such as “破”(kanji that stands for “break”) / “排”(drainage) / “膿”(pus) or “義歯”(denture)/ “印象”(impression) seemingly associated with tooth extraction or dentures respectively were frequently used in the medical records with 147 out of 1498 patients (medical records amounting to 9724) from January 2016 to June 2018, who underwent tooth extraction during the period. On the other hand, words related to oral hygiene, such as “floss”, “early”, “tartar”, and “plaque”, were frequently used in the medical records of 1351 patients who did not have their teeth extracted. How to apply these results to clinical practice is a topic for the future, but data can be analyzed from a different perspective than human insights, suggesting future usefulness in dental practice.

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In clinical dental practice based on regular check-ups by dental hygienists, intraoral standard photography is a basic integrant. In recent years, patients' awareness of oral mucosal diseases increased. Early detection is important for the appropriate treatment of the disease, and for that purpose, recording of the oral mucosa in a healthy state is an important reference for diagnosis. In this report, we summarize the standardization method of intraoral photography based on NIDCR data.

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This survey was conducted to investigate oral health status of new patients at dental clinics practicing routine maintenance. Subjects were collected in anonymised digital format from Japan Health Care Dental Association (JHCDA) member clinics. The subjects of this 12th survey included 12,684 new patients (5,448 male and 7,236 female patients) who visited the 52 member clinics (across 24 prefectures) during the period between January 1st and December 31st, 2017. For children and minors, the DMFT scores were recorded, and for adults the DMFT scores, the number of remaining teeth, the condition of periodontal tissues and smoking status were recorded. As a result, the DMFT index continued to decrease across all age groups above 12 years old; the prominent decrease of male smoking population across all age groups continued; and the number of remaining teeth continued to increase across age groups above 65 years old in both male and female population. Also, the subjects were divided into 4 groups based on the amount of municipal or ward tax according to the location of the participating clinics. The findings include; ① inter-regional economic disparities were reflected in DMFT index in relation to the number of children with pronouncedly high caries experience; and ② in the population 50 years old and over, tax-amount-per-capita and the average remaining teeth are directly proportional among 4 groups—the higher the local tax the more remaining teeth, as seen in the last year’s result, but the narrowing trend over time was observed in the health disparities.

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